Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health Transition”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,243 records · Page 69Linked to original sources
PubMed2006

Health shocks, employment and income in the Spanish labour market.

This paper investigates the relationship between health shocks and labour outcomes in the Spanish population using the European Community Household Panel. In order to control for the non-experimental nature of the data we use difference in difference and matching techniques. Our results suggest that there is a significant effect running from health to the probability of employment and to labour income. Moreover, while we cannot investigate the influence of childhood events and other phenomena that trigger long run causal pathways from socio-economic status to health, we are able to find a significant reduction in the probability of reporting good health in individuals who transit out of employment in comparison with individuals who are otherwise identical in terms of reported health status at the time of the transition.

Empirical Research↗
PubMed1998

An analysis of extended survival in patients with amyotrophic lateral sclerosis treated with riluzole.

BACKGROUND: In an attempt to better understand and define the progression of amyotrophic lateral sclerosis (ALS), we developed a classification of 5 discrete health states that reflect patients' activities of daily living. These health states were used to determine whether patients with ALS who are treated with riluzole differed from those treated with placebo. SETTING: Clinics for patients with ALS. DESIGN: Placebo-controlled trial of riluzole treatment in 959 patients with ALS. INTERVENTIONS: Treatment with riluzole or placebo. MAIN DEPENDENT MEASURES: A Cox model was used to assess whether, from the initial randomization to the end of an 18-month follow-up, there was a difference in the times of transition into subsequent health states between patients treated with riluzole and those treated with placebo. RESULTS: Our analysis showed a significant difference in the time to transit between the riluzole and the placebo groups in less severely affected cases, ie, state 2 and state A (the milder states) of ALS. CONCLUSION: Patients receiving riluzole remained in the milder health states longer (P<.05).

Amyotrophic Lateral Sclerosis↗
PubMed2004

Educational and behavioral issues in transitioning from pediatric cardiology to adult-centered health care.

It is assumed that when they begin growing up, a child with congenital heart disease will take personal responsibility for his or her care. For this purpose, patients need sufficient knowledge on the heart defect, treatment,and measures to prevent complications. However, empirical studies indicated that the levels of knowledge and understanding of both parents and children with congenital heart disease are poor. Therefore, sound patient education is imperative, particularly when patients are transitioned from pediatric cardiology to adult congenital cardiology. In this respect, the focus of communication shifts from the parent to the young patient; moreover, education should be tailored according to the developmental level of the patient. Issues that should typically be covered by educational programs for adolescents with congenital heart disease are information on the heart defect, treatment, endocarditis, sexuality and reproduction, sports, employability and insurability, and cardiovascular risk factor. International guidelines indicate that advanced practice nurses are key in developing and implementing patient education programs during the transition from pediatric cardiology to adult-centered health care.

Adolescent↗
PubMed1999

Relative effectiveness and cost-effectiveness of methods of androgen suppression in the treatment of advanced prostate cancer.

OBJECTIVES: With 184,500 new cases and 39,200 deaths anticipated in 1998, prostate cancer is second only to lung cancer in cancer mortality for men. This report is a systematic review of the evidence from randomized controlled trials on the relative effectiveness of alternative strategies for androgen suppression as treatment of advanced prostate cancer. Three key issues are addressed: (1) the relative effectiveness of the available methods for monotherapy (orchiectomy, luteinizing hormone-releasing hormone [LHRH] agonists, and antiandrogens), (2) the effectiveness of combined androgen blockade compared to monotherapy, and (3) the effectiveness of immediate androgen suppression compared to androgen suppression deferred until clinical progression. Outcomes of interest are overall, cancer-specific, and progression-free survival; time to treatment failure; adverse effects; and quality of life. Two supplementary analyses were conducted for each key question: (1) meta-analysis of overall survival at 2 years (questions 1 and 2) and 5 years (questions 2 and 3), and (2) cost-effectiveness analysis. SEARCH STRATEGY: The MEDLINE, CANCERLIT, and EMBASE databases were searched from 1966 to March 1998, and Current Contents to August 24, 1998, for the terms: leuprolide (Lupron); goserelin (Zoladex); buserelin (Suprefact); flutamide (Eulexin); nilutamide (Anandron, Nilandron); bicalutamide (Casodex); cyproterone acetate (Androcur); diethylstilbestrol (DES); and orchiectomy (castration, orchidectomy). The search was then limited to human studies indexed under the MeSH term "prostatic neoplasms" and by the UK Cochrane Center search strategy for randomized controlled trials. Total yield was 1,477 references. SELECTION CRITERIA: We Reports of efficacy outcomes were limited to randomized controlled trials. Phase II studies that reported on withdrawals from therapy and all studies reporting on quality of life were also included. DATA COLLECTION AND ANALYSIS: The systematic review used a prospectively designed protocol conducted by two independent reviewers, with disagreements resolved by consensus. The meta-analysis combined data on overall survival using a random effects model. The cost-effectiveness analysis used a decision analysis model of advanced prostate cancer with health states and transitions derived from the literature and estimates of effectiveness derived from the meta-analysis. The cost-effectiveness analysis is conducted from a societal perspective, consistent with the guidelines of the U.S. Public Health Service Panel on Cost-Effectiveness in Health and Medicine. MAIN RESULTS: Survival after treatment with an LHRH agonist is equivalent to survival after orchiectomy. The available LHRH agonists are equally effective, and no LHRH agonist is superior to the other when adverse effects are considered. Survival may be somewhat lower with use of a nonsteroidal antiandrogen. There is no statistically significant difference in survival at 2 years between patients treated with combined androgen blockade or monotherapy. Meta-analysis of the limited data available shows a statistically significant difference in survival at 5 years that favors combined androgen blockade. However, the magnitude of this difference is of questionable clinical significance. For the subgroup of patients with good prognosis, there is no statistically significant difference in survival. Adverse effects leading to withdrawal from therapy occurred more often with combined androgen blockade. No evidence is yet available from randomized controlled trials of androgen suppression initiated at prostate-specific antigen (PSA) rise after definitive therapy for clinically localized disease. For patients who are newly diagnosed with locally advanced or asymptomatic metastatic disease, the evidence is insufficient to determine whether primary androgen suppression initiated at diagnosis improves outcomes. (ABSTRACT TRUNCATED)

Androgen Antagonists↗
PubMed2005

Use of Internet audience measurement data to gauge market share for online health information services.

BACKGROUND: The transition to a largely Internet and Web-based environment for dissemination of health information has changed the health information landscape and the framework for evaluation of such activities. A multidimensional evaluative approach is needed. OBJECTIVE: This paper discusses one important dimension of Web evaluation-usage data. In particular, we discuss the collection and analysis of external data on website usage in order to develop a better understanding of the health information (and related US government information) market space, and to estimate the market share or relative levels of usage for National Library of Medicine (NLM) and National Institutes of Health (NIH) websites compared to other health information providers. METHODS: The primary method presented is Internet audience measurement based on Web usage by external panels of users and assembled by private vendors-in this case, comScore. A secondary method discussed is Web usage based on Web log software data. The principle metrics for both methods are unique visitors and total pages downloaded per month. RESULTS: NLM websites (primarily MedlinePlus and PubMed) account for 55% to 80% of total NIH website usage depending on the metric used. In turn, NIH.gov top-level domain usage (inclusive of NLM) ranks second only behind WebMD in the US domestic home health information market and ranks first on a global basis. NIH.gov consistently ranks among the top three or four US government top-level domains based on global Web usage. On a site-specific basis, the top health information websites in terms of global usage appear to be WebMD, MSN Health, PubMed, Yahoo! Health, AOL Health, and MedlinePlus. Based on MedlinePlus Web log data and external Internet audience measurement data, the three most heavily used cancer-centric websites appear to be www.cancer.gov (National Cancer Institute), www.cancer.org (American Cancer Society), and www.breastcancer.org (non-profit organization). CONCLUSIONS: Internet audience measurement has proven useful to NLM, with significant advantages compared to sole reliance on usage data from Web log software. Internet audience data has helped NLM better understand the relative usage of NLM and NIH websites in the intersection of the health information and US government information market sectors, which is the primary market intersector for NLM and NIH. However important, Web usage is only one dimension of a complete Web evaluation framework, and other primary research methods, such as online user surveys, usability tests, and focus groups, are also important for comprehensive evaluation that includes qualitative elements, such as user satisfaction and user friendliness, as well as quantitative indicators of website usage.

Humans↗
PubMed2003

A pharmacoeconomic evaluation of 7-valent pneumococcal conjugate vaccine in Canada.

The objective of this study was to evaluate the projected health benefits, costs, and cost-effectiveness of pneumococcal conjugate vaccination for infants and children aged <5 years in Canada. A health state model incorporating incidence, vaccine efficacy, costs, and transitional probabilities for the health states (well, meningitis, bacteremia, otitis media, pneumonia, and death) was constructed for a 10-year time horizon. Implementation of a pneumococcal conjugate vaccine program in Canada for each annual birth cohort of 340,000 persons observed over 10 years would be expected to save approximately 12 lives and 100,000 cases of pneumococcal disease over 10 years, resulting in total savings of $67 million (Canadian dollars [Can$]). Vaccination of healthy infants would result in net savings for society if the vaccine costs less than Can$50 per dose. Moreover, for a vaccine purchase price of Can$67.50, infant vaccination would cost society Can$79,000 per life-year gained. Pneumococcal conjugate vaccination is a potentially cost-effective means of pneumococcal disease prevention.

Canada↗
PubMedDate not supplied

Shortened lengths of stay: ensuring continuity of care for mothers and babies.

Hospital discharge on the day after an uncomplicated vaginal delivery may be appropriate if clinical criteria are used for the selection of patients and post-discharge follow-up plans are in place. To ensure safety for these patients, Advocate Health Care developed a mother/baby philosophy statement, guidelines for maternal and infant discharge in less than 48 hours, and an algorithm to assure that appropriate follow-up care takes place after discharge. To evaluate the Mother/Baby Home Transition Program, home health follow up, readmission rates, and sentinel events were tracked. Most home health visits occurred within 48 hours. Infant readmission rates ranged from 1.1-2.6%, whereas maternal readmission rates ranged from 0-0.52%. Three sentinel events in 1996 and three in 1997 required readmissions to an ICU. Data continue to be monitored and shared monthly with clinical leaders.

Adult↗
PubMedDate not supplied

A model of care for childhood cancer survivors that facilitates research.

The majority of children and adolescents diagnosed with cancer will achieve long-term survival after contemporary therapy. Consequent to this success are challenges inherent in coordinating lifelong health care for a group predisposed to a variety of cancer-related complications. With increasing numbers of aging adult survivors of childhood cancer, clinicians now face the additional challenge of studying delayed effects of childhood cancer in the context of organ senescence. Clinicians must also address the transition of survivor health care from the pediatric oncology setting to the adult community. Salient issues influencing health care of long-term childhood cancer survivors are summarized, and a model for monitoring late treatment effects used at a pediatric cancer facility is presented. This model is remarkable for its ability to enhance optimal delivery of long-term survivor care, facilitate the transition of survivor care from the pediatric treatment center to community, providers, and support investigations of late cancer-related morbidity and mortality.

Adolescent↗
PubMed2000

Medicaid managed care and provider consolidation.

In the thrust toward constructing economic value, health care provider firms have been consolidating at a marked rate. Medicaid managed care programs have been rapidly emerging with the objectives of containing health care costs and improving services for beneficiaries. However, there are concerns that the trend toward achieving market efficiency through merger is largely incongruent with the economic and health value objectives of Medicaid managed care programs in the states. Discordance among value objectives arises primarily because of inefficient and market concentrating horizontal merger strategies employed by firms and disruptions in quality of care that occur during the transition to integrated health care systems. By promoting vertical integration strategies and filling in the quality gaps created by an active merger environment, Medicaid offices advance state objectives of cost containment and quality while recognizing that providers operate in a complex and competitive environment that necessitates consolidation for organizational survival.

Cost Control↗
PubMed2005

Private health insurance: implications for developing countries.

Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage.

Developing Countries↗
PubMed2001

Locum tenens--a concept it is time for dentistry to embrace.

As shown by success in other health professions, dentists can effectively stand in for other dentists who need to be absent from their offices for reasons of health, family matters, education, and many similar reasons. Locum Tenens agencies can facilitate such temporary substitutions and are especially valuable in maintaining productive use of fixed overhead. Examples of situations where a Locum Tenens arrangement may be beneficial include practice transitions necessitated by health problems, educational opportunities, temporary leaves due to pregnancy or other family matters, wellness interventions, and management of dentist shortage areas.

Contract Services↗
PubMed1998

All change: cancer services in transition.

The policy and health service background to this discussion are the radical changes in cancer services currently underway in the wake of the Calman-Hine Report and the wider changes ushered in by the NHS and Community Care Act 1990 (UK). Using the changing face of hospice care as the focus, the authors explore some of the potential issues and dilemmas involved in providing supportive care for cancer patients and their families. Three 'themes', or areas of concern, are highlighted: links between services, changing organizational factors, and increasing 'medical imperialism'. Potential benefits and drawbacks of the changing ethos and organizational structures are discussed. Interview data are used as 'triggers' for the presentation of the authors' own reflections on developments in the hospice and cancer services' arenas. The paper draws on interview data collected in the pilot phase of a 3-year study on the psycho-social needs of cancer patients and their informal carers in north-west England. Twenty-nine interviews were conducted with a range of professionals involved in the provision of cancer services in Lancaster and Kendal. In the spirit of 'gathering thoughts' and facilitating debate, a commentary on developments in the hospice sector is offered rather than any firm conclusion.

Health Care Reform↗
PubMed2005

Effects of marital transitions on changes in dietary and other health behaviours in US male health professionals.

STUDY OBJECTIVE: To examine the effect of change in marital status on health behaviours among men. DESIGN: Longitudinal study of repeated measures of marital status and health behaviours collected at four year intervals (1986-90; 1990-94). SETTING: US male health professionals. PARTICIPANTS: 38 865 men aged 40-75 in 1986. MAIN RESULTS: Relative to men who stayed married over four years, men who became widowed increased their alcohol consumption. Men who become divorced or widowed experienced decreases in body mass index. Compared with men who remained unmarried, men who remarried exhibited increases in body mass index along with decreased physical activity. Becoming divorced or widowed was associated with decreased vegetable intake while remarriage was linked to greater consumption. CONCLUSIONS: Marital termination may adversely affect health and dietary behaviours among men.

Adult↗
PubMedDate not supplied

The First-Time Fathers Study: a prospective study of the mental health and wellbeing of men during the transition to parenthood.

OBJECTIVE: In comparison to its female counterpart, the transition of men to parenthood has been relatively neglected in previous research. The present paper argues that men may have gender-specific risk factors for perinatal psychological distress and may manifest distress in ways different from women. The prime objective of this research was to document changes in psychological, relationship and lifestyle parameters in a cohort of first time fathers from pregnancy to the end of the first postnatal year. The present paper reports on these changes. METHOD: Three hundred and twelve men were assessed at 23 weeks of pregnancy and followed up at 3, 6 and 12 months postnatally, using a battery of self-report questionnaires covering psychological symptom levels, lifestyle variables and relationship/sexual functioning. Two hundred and four men completed all four assessments. RESULTS: The men exhibited highest symptom levels in pregnancy with general, through small, improvement at 3 months and little change thereafter. Lifestyle variables showed small changes over the first postnatal year. Sexual functioning appeared to deteriorate markedly from pre-pregnancy levels with only minimal recovery by the end of the first year. The results highlight that the majority of men anticipated return of sexual activity to pre-pregnancy levels; however, this failed to eventuate. CONCLUSIONS: Pregnancy, rather than the postnatal period, would appear to be the most stressful period for men undergoing the transition to parenthood. The results suggest that the most important changes occur relatively early in pregnancy. Thereafter, lack of change (rather than change) is the most noteworthy feature. These men appeared to be ill-prepared for the impact of parenthood on their lives, especially in terms of the sexual relationship. Further research to determine the timing and trigger of stress in pregnancy is recommended.

Adaptation, Psychological↗
PubMed1993

Computer software for health care CQI.

The transition from quality assurance to continuous quality improvement (CQI) demands a basic change from centralized to decentralized information management. In CQI, front-line staff can use personal computer (PC) software skills to manage, analyze, and act on process-related information. Information services departments play a key role in this transition by, among other things, selecting software that optimally supports the PC-based work carried out by CQI teams. A review of typical CQI team software requirements and of available PC software suggests that Microsoft Excel 4.0 is a nearly ideal software platform to support CQI teams.

Management Information Systems↗